title: Staphylococcus aureus infections in US veterans, Maryland, USA, 1999-2008.
abstract: Trends in Staphylococcus aureus infections are not well described. To calculate incidence in overall S. aureus infection and invasive and noninvasive infections according to methicillin susceptibility and location, we conducted a 10-year population-based retrospective cohort study (1999-2008) using patient-level data in the Veterans Affairs Maryland Health Care System. We found 3,674 S. aureus infections: 2,816 (77%) were noninvasive; 2,256 (61%) were methicillin-resistant S. aureus (MRSA); 2,517 (69%) were community onset, and 1,157 (31%) were hospital onset. Sixty-one percent of noninvasive infections were skin and soft tissue infections; 1,112 (65%) of these were MRSA. Ten-year averaged incidence per 100,000 veterans was 749 (± 132 SD, range 549-954) overall, 178 (± 41 SD, range 114-259) invasive, and 571 (± 152 SD, range 364-801) noninvasive S. aureus infections. Incidence of all S. aureus infections significantly increased (p<0.001), driven by noninvasive, MRSA, and community-onset infections (p<0.001); incidence of invasive S. aureus infection significantly decreased (p<0.001).
authors.affiliation: University of Maryland, Department of Epidemiology and Public Health, 685 W Baltimore St, MSTF 336, Baltimore, MD 21201, USA. laree.tracy@fda.hhs.gov
authors.forename: LaRee A
authors.initials: LA
authors.lastname: Tracy
authors.forename: Jon P
authors.initials: JP
authors.lastname: Furuno
authors.forename: Anthony D
authors.initials: AD
authors.lastname: Harris
authors.forename: Mary
authors.initials: M
authors.lastname: Singer
authors.forename: Patricia
authors.initials: P
authors.lastname: Langenberg
authors.forename: Mary-Claire
authors.initials: MC
authors.lastname: Roghmann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D015331:Cohort Studies; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000382:microbiology; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008396:Maryland / Q000453:epidemiology; D008712:Methicillin / Q000494:pharmacology; D016106:Methicillin Resistance; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification; D008875:Middle Aged; D018461:Soft Tissue Infections / Q000453:epidemiology; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D013207:Staphylococcal Skin Infections / Q000453:epidemiology; D013211:Staphylococcus aureus / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D008712:Methicillin